Gastric tumors in children: single-center study with emphasis on treatment of repeated recurrence
PEDIATRIC SURGERY INTERNATIONAL
Authors: Petrasova, Natalia; Snajdauf, Jiri; Petru, Ondrej; Frybova, Barbora; Svojgr, Karel; Linke, Zdenek; Mixa, Vladimir; Kodet, Roman; Kyncl, Martin; Rygl, Michal
Abstract
Purpose Analysis of surgical management and survival of pediatric patients with gastric tumors treated at our institution. Methods A retrospective study of patients with primary gastric tumors treated between 1993 and 2018 was conducted. Results Eight patients, five girls and three boys, were diagnosed with gastric tumors at an average age of 10.4 years (1 day-15.4 years). Surgical management included Billroth type I procedure in five and tumor excision in three patients. Histology revealed gastrointestinal stromal tumor (GIST) in four patients and one of each of schwannoma, myofibroblastic tumor, hamartoma and teratoma. Microscopically clear margins were reported in six patients. Repeated local recurrence occurred in three patients (2 x GIST, 1 x myofibroblastic tumors) who consequently underwent three, four and six reoperations. One of these patients had liver metastases, which were managed with ligation of the hepatic arteries. This patient was also diagnosed with a lung hamartoma, which was treated with a lobectomy. Survival rate was 100% with a median follow-up of 8.6 years (7 months-25.5 years). Conclusions Gastric tumors are rare in children and represent a management challenge. Repeated recurrence of GISTs and myofibroblastic tumors remains frequent even after complete resection and may necessitate multiple surgeries, therefore patients require a lifelong follow-up.
Making NSCLC Crystal Clear: How Kinase Structures Revolutionized Lung Cancer Treatment
CRYSTALS
Authors: Vilacha, Juliana F.; Mitchel, Sarah C.; Akele, Muluembet Z.; Evans, Stephen; Groves, Matthew R.
Abstract
The parallel advances of different scientific fields provide a contemporary scenario where collaboration is not a differential, but actually a requirement. In this context, crystallography has had a major contribution on the medical sciences, providing a "face" for targets of diseases that previously were known solely by name or sequence. Worldwide, cancer still leads the number of annual deaths, with 9.6 million associated deaths, with a major contribution from lung cancer and its 1.7 million deaths. Since the relationship between cancer and kinases was unraveled, these proteins have been extensively explored and became associated with drugs that later attained blockbuster status. Crystallographic structures of kinases related to lung cancer and their developed and marketed drugs provided insight on their conformation in the absence or presence of small molecules. Notwithstanding, these structures were also of service once the initially highly successful drugs started to lose their effectiveness in the emergence of mutations. This review focuses on a subclassification of lung cancer, non-small cell lung cancer (NSCLC), and major oncogenic driver mutations in kinases, and how crystallographic structures can be used, not only to provide awareness of the function and inhibition of these mutations, but also how these structures can be used in further computational studies aiming at addressing these novel mutations in the field of personalized medicine.